Administrative Review Tribunal (Consequential and Transitional Provisions No. 1) Act 2024 (the Transitional Act) (Cth)

Administrative Review Tribunal Act 2024 (Cth) s105

National Disability Insurance Scheme Act 2013 (Cth) s10, s33, s34, s35, s103

National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No 1) Act 2024 (Cth)- s129

National Disability Insurance Scheme (Supports for Participants) Rules 2013 (Cth)

National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 (Cth)

G v Minister for Immigration and Border Protection [2018] FCA 1229

McGarrigle v National Disability Insurance Agency [2017] FCA 308

National Disability Insurance Agency v WRMF [2020] FCAFC 79

Re Drake v Minister for Immigration and Ethnic Affairs (No 2) (1979) 2 ALD 60

XYZ v Commonwealth [2006] HCA25; [2006] HCA 25; (2006) 227 CLR 532

Minister for Home Affairs v G [2019] FCAFC 79

National Disability Insurance Agency v Lampard [2025] FCAFC 139

TZQP v National Disability Insurance Agency [2025] ARTA 839

Garcia Albiol v NDIA [2024] AATA 496.

NDIS - Operational Guidelines - Reasonable and necessary supports

2025- 2026 NDIS Pricing Arrangement and Price Limits dated 16 June 2025

1. Ms Gerada, a 70-year-old woman, has been a participant of the National Disability Insurance Scheme ('the scheme') since June 2018.
2. Ms Gerada became a participant in the scheme on the basis of having met the 'disability requirements' due to psychosocial impairments as a consequence of major depressive disorder, other anxiety disorders and obsessive-compulsive disorder ('OCD').
3. On 26 August 2024 Ms Gerada made a request pursuant to section 48 of the National Disability Insurance Scheme Act 2013 ('the NDIS Act'). In doing so Ms Gerada sought to have fibromyalgia, irritable bowel syndrome (IBS) and agoraphobia ('the conditions') listed as conditions for the purposes of her access to the scheme.
4. On 24 September 2024 Ms Gerada's request was declined by the Agency. Ms Gerada thereafter requested an internal review of this decision.
5. On 28 November 2024 a delegate of the National Disability Insurance Agency ('the Agency') approved a statement of participant supports ('SOPS') for Ms Gerada.[1] Dissatisfied with her SOPS, on 16 December 2024 Ms Gerada requested a review of her SOPS by the Agency. At that time Ms Gerada again requested that fibromyalgia and IBS be recognised as conditions for the purposes of her funding under the scheme.
6. The Agency conducted an internal review and on 14 February 2025 confirmed its original decision, which was to not recognise the conditions as sought by Ms Gerada ('the decision under review') for the purposes of funding under the scheme.[2]
7. On 3 April 2025 Ms Gerada applied to the Administrative Appeals Tribunal ('AAT') for a review of the decision under review. The Agency has since implemented a subsequent plan.[3] Pursuant to section 103 of the NDIS Act this plan is taken to be reviewable. The current plan commenced on 25 August 2025.[4] ('current plan').
8. From 14 October 2024, the AAT became the Administrative Review Tribunal ('the Tribunal'). Under the transitional provisions in the Administrative Review Tribunal (Consequential and Transitional Provisions No. 1) Act 2024 ('the Transitional Act'), applications for review to the AAT that were not finalised before 14 October 2024 are taken to be an application for review to the Tribunal. The Transitional Act gives the Tribunal the authority to continue and finalise any aspect of the review not already completed by the AAT. This decision and statement of reasons is made by the Tribunal.
9. Ms Gerada attended the hearing and was self-represented. The Agency was represented by Ms Josephine Thornton of Counsel, instructed by Moray Agnew.

1. For the purposes of the Tribunal's review Ms Gerada sought that her impairments as a consequence of fibromyalgia and IBS be recognised for the purposes of her funding under the scheme. Ms Gerada also sought the following eight supports for inclusion in her SOPS on the basis that they were 'reasonable and necessary supports' for the purposes of section 34 of the NDIS Act[5]:
   • 42 hours of support worker assistance per week being:
   • 19 hours at the weekday standard rate;
   • 6 hours at the weekday evening rate;
   • 5 hours at the Saturday rate;
   • 5 hours at the Sunday rate; and
   • 7 hours of travel time weekly for support workers (with an additional 11 hours per annum for public holidays).
   • Occupational Therapy - 85 hours per year consisting of 67 hours per year plus 18 hours of travel time for the OT;
   • $4,248.96 for continence products;
   • $600 for custom orthotics;
   • Low cost Assistive Technology - $1,500;
   • Physiotherapy - 26 hours per year plus travel funding;
   • Exercise physiology - 26 hours per year plus travel funding;
   • Podiatry - 7 hours
2. In her application to the Tribunal Ms Gerada stated;

All evidence indicates the diagnosis are permanent lifelong and are debilitating in functional impact. there are no cures for both and doctors

continually treat Debra for a life-long disability and not a medical condition. Debra is not living with dignity and is not funded adequately on her NDIS plan.[6]

1. In seeking the funding of these supports under the scheme Ms Gerada contends:
   • Firstly, that she continues to meet the 'disability requirements', pursuant to section 24 of the NDIS Act, in respect of her psychosocial impairments as referred to in [2]; and
   • Secondly, that she now also meets the 'disability requirements' as a result of physical impairments as a consequence of fibromyalgia and irritable bowel syndrome (IBS) which is linked to agoraphobia.
2. In summary, Ms Gerada seeks to rely on both her psychosocial impairments and her physical impairments as a basis for the funding the supports that she seeks under the scheme.

National Disability Insurance Scheme Act 2013 (Cth) (the NDIS Act)

1. On 3 October 2024, and prior to the completion of this review, the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No 1) Act 2024 ('the Amending Act') made a range of 'amendments' to the NDIS Act_._
2. The amendments in respect of the requirements pursuant to section 34 of the NDIS Act will apply to this review.[7]
3. Section 34 of the NDIS Act (as amended) identifies what constitutes a 'reasonable and necessary' support under the scheme for funding in a participant's SOPS. Section 34 of the NDIS Act for the purposes of this review provides as follows:

(1) For the purposes of specifying, in a statement of participant supports, the general supports that will be provided, and the reasonable and necessary supports that will be funded, the CEO must be satisfied of all of the following in relation to the funding or provision of each such support:

(aa) the support is necessary to address needs of the participant arising from an impairment in relation to which the participant meets the disability requirements (see section 24) or the early intervention requirements (see section 25);

(a) the support will assist the participant to pursue the goals, objectives and aspirations included in the participant's statement of goals and aspirations;

(b) the support will assist the participant to undertake activities, so as to facilitate the participant's social and economic participation;

(c) the support represents value for money in that the costs of the support are reasonable, relative to both the benefits achieved and the cost of alternative support;

(d) the support will be, or is likely to be, effective and beneficial for the participant, having regard to current good practice;

(e) the funding or provision of the support takes account of what it is reasonable to expect families, carers, informal networks and the community to provide;

(f) the support is an NDIS support for the participant.

.........................................................................................

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(2) The National Disability Insurance Scheme rules may prescribe methods or criteria to be applied or matters to which the CEO is to have regard, in deciding whether or not he or she is satisfied as mentioned in any of paragraphs (1)(aa) to (f). (emphasis of amendments)

1. Subsection 34(1) of the NDIS Act is cumulative and therefore all the criteria must be met.
2. Of particular relevance to this review was the insertion of subsection 34(1)(aa) of the NDIS Act, which I will refer to subsequently in this decision
3. Subsection 34(2) of the NDIS Act provides that the NDIS Rules may prescribe methods or criteria to be applied, or matters to which the CEO must have regard, in deciding whether the criteria under subsection 34(1) of the NDIS Act are met in respect of a requested support.
4. Section 35 of the NDIS Act provides for the making of rules in relation to prescribing reasonable and necessary supports or general supports that will be funded or provided under the NDIS. The relevant rules in respect of this review are the:
   • National Disability Insurance Scheme (Supports for Participants) Rules 2013 ('Supports Rules');
   • National Disability Insurance Scheme (Getting the NDIS Back on Track No. 1) (NDIS Supports) Transitional Rules 2024 ('Transitional Rules'); and
5. In McGarrigle v National Disability Insurance Agency[8] at [43], Mortimer J (as Her Honour then was) made the following observations in respect of these rules:

The [Supports Rules] are an important element of the legislative scheme, introducing the ability to modify the operation of ss 33 and 34 by, for example, excluding certain kinds of supports from inclusion in participant plans. It is through the Rules that the executive is able to implement...some policy decision-making about the nature and extent of supports to be provided or funded.

6. The phrase 'reasonable and necessary' is not defined in the Act. It is a composite phrase and should be considered as such. In McGarrigle, Mortimer J also stated as follows:[9]

Whether a support is "reasonable" requires a different assessment to whether a support is "necessary". Again, it is not necessary in the context of this proceeding to be definitive about the nature and extent of the meaning of the phrase, or its components. It is enough to observe that using the concept of necessity would appear to tie one aspect of the CEO's assessment to an evaluation of the kinds of factors set out in s 34(1)(a) and (b) and (d). The word "reasonable" would appear to be directed at factors such as those set out in s 34(1)(c) and (f). That is not to say the meaning of each word is exhausted by the factors set out in s 34(1): rather, it is to illustrate the different work that each concept does as an adjective in the phrase "reasonable and necessary supports".

7. The Full Court in National Disability Insurance Agency v WRMF[10] also considered the meaning of reasonable and necessary supports, and stated as follows [149]- [151]:

The phrase is a composite phrase. We accept the Agency's submissions that each limb of the phrase should be given work to do. That task is not difficult, or complicated with these two particular words, which are readily understood as conveying different meanings. However, the Parliament has chosen to use a composite phrase rather than to stipulate two distinct requirements, and therefore, as Gleeson CJ cautioned in XYZ v Commonwealth [2006] HCA25; [2006] HCA 25; (2006) 227 CLR 532 at [19], '[t]here are many instances where it is misleading to construe a composite phrase simply by combining the dictionary meanings of its component parts'. > > ... Both adjectives qualify the noun "support", but they do so as a composite phrase. It is not fruitful to split them off and consider them separately, just as it is neither fruitful nor appropriate to attempt any exhaustive or authoritative judicial definition of them. > > Nevertheless, there is no doubt that the contextual use of the phrase in this Act links it to public funding to be provided to a participant. In that context, the phrase connotes supports which meet a threshold which justifies - by reference to the context, objects and guiding principles of the Act and the facts of the case - the expenditure of public funds for that support, for a particular participant. As we have already explained, the phrase also needs to be understood taking into account what has qualified a person as a participant, and the links between a person's impairment and their full participation in the community, in the same variety of ways as persons without a disability might choose to participate.

1. The Agency also issues Operational Guidelines in relation to what are considered 'reasonable and necessary supports' in a participant's plan. There is no power conferred by the Act to make these Operational Guidelines, and they are issued in an exercise of executive power.[11] The Tribunal is therefore not bound by any policy set out in the Agency's Operational Guidelines. However, in Re Drake and Minister for Immigration and Ethnic Affairs (No 2)[12] the Federal Court held that a Tribunal should take into account relevant government policy which is not inconsistent with the provisions or objects of the legislation. Further guidance for the proposition that the Tribunal is not bound by policy is found in G v Minister for Immigration and Border Protection[13] where Mortimer J held:[14]

Justice or injustice is not found within a policy. It is found by looking at the overall circumstances of an individual's case with the principal focus being on the purpose and context of the statutory power, not the executive policy framed to guide it.

2. Accordingly, unless the Operational Guidelines are inconsistent with the provisions or objects of the legislation, they should be considered in a determination of what is a reasonable and necessary support for Ms Gerada. They should also be considered in relation to whether Ms Gerada meets the disability requirements in respect of her impairments due to Fibromyalgia and IBS. The Guidelines relevant to this review are the:
   • NDIS - Operational Guidelines - Reasonable and necessary supports (the Supports Guidelines'); and
   • NDIS - Operational Guidelines - Apply to the NDIS ('the Access Guidelines').

1. I have considered all the written evidence filed with the Tribunal and provided in the joint bundle, the oral evidence provided at the hearing on 3, 4, 5, 6, 7 and 13 November 2025, and the parties' closing submissions. I will refer in my decision to some of the more salient aspects of the evidence. The fact however that I do not refer to all parts of the evidence does not mean that I have not taken all evidence before the Tribunal into account in reaching my decision.

1. As stated, Ms Gerada was granted access to the scheme due to psychosocial impairments as a consequence of major depressive disorder, other anxiety disorders and obsessive compulsive disorder ('OCD').
2. Ms Gerada states that she continues to be affected by her psychosocial impairments that arise as a consequence of these conditions. She explains that her psychosocial impairments include the following:
   • Depression;
   • Difficulties engaging in tasks and organising her thoughts;
   • Anxiety including debilitating instructive thoughts;
   • Episodes of crying;
   • Sleep difficulties.[15] ('psychosocial impairments')
3. Ms Gerada contends that that she continues to meet the 'disability requirements' as a consequence of her psychosocial impairments and having regard to the criteria under section 24 of the NDIS Act. In this regard she contends that:
   • her psychosocial impairments are permanent - Section 24(1) (b) NDIS Act;
   • her psychosocial impairments result in a substantial reduction in her functional capacity to undertake the activities of communication, social interaction, learning, mobility, self-care and self-management - Section 24(1) (c) NDIS Act;
   • her psychosocial impairments affect her capacity for social and economic participation - section 24(1)(d) NDIS Act;
   • she is likely to require NDIS supports under the scheme for her lifetime - Section 24(1) (e) NDIS Act.
4. Ms Gerada explained that over the years she has trialled approximately 18 different antidepressants and her depression is now deemed to be 'treatment resistant'. She has also received electroconvulsive therapy ('ECT').
5. Ms Gerada described her OCD as a continual process of 'checking and checking' and gave an example of continually checking whether her doors are locked.

1. Ms Gerada was diagnosed with Irritable bowel syndrome ('IBS') approximately 15 years ago[16]
2. Ms Gerada contends that she now also meets the 'disability requirements' as a consequence of physical impairments due to IBS.
3. These physical impairments include the following:
   • frequent and unpredictable bowel urgency, often resulting in 'accidents',[17]
   • epigastric pain;
   • episodes of agoraphobia (as a psychosocial impairment also);
   • on a good day she will have three episodes of unpredictable bowel urgency;
   • on a bad day she may have between 7 to 10 episodes of unpredictable bowel urgency;
   • generally, on a moderate day she experiences 4 to 5 episodes of unpredictable bowel urgency;
   • her bowel urgency is always associated with diarrhoea;
   • she needs to remain close to a toilet and at all times and feels anxious if she is not in the vicinity of a toilet;
   • her episodes of bowel urgency are a cause of great embarrassment and require immediate attention.('impairments due to IBS'}
4. Ms Gerada explained that she was diagnosed with agoraphobia in or about 2002 by Dr Howard Granger, psychiatrist. Agoraphobia is described as is an anxiety disorder characterized by symptoms of anxiety in situations where the person perceives their environment to be unsafe with no way to escape. These situations can include public transit, shopping centres, crowds and queues, or simply being outside their home on their own. Being in these situations may result in a panic attack. Those affected will go to great lengths to avoid these situations. In severe cases, people may become completely unable to leave their homes.[18]
5. In her report dated 22 August 2024 Laura Etherington, psychologist refers to Ms Gerada's diagnosis of agoraphobia by Dr Grainger around 2002.[19] Ms Etherington states,

'There is a perpetuating cycle of stress and anxiety triggering her symptoms of her IBS, which in turn increase the intensity of her fear and anxiety of leaving her home'

1. Ms Gerada explains that her agoraphobia has been exacerbated over the years as a consequence of her IBS. She now finds it difficult to leave her home and venture beyond her garden.
2. Ms Gerada contends that her impairments due to IBS:
   • are permanent- section 24(1)(b) NDIS Act;
   • substantially reduce her functional capacity to undertake social interaction, mobility, and self-care. - section 24(1)(c ) NDIS Act. Ms Gerada states that her functional capacity to communicate and self-manage is 'impacted' upon by her physical impairment due to IBS. Ms Gerada accepts that her ability to engage in learning is not impacted upon by her physical impairment due to IBS.
   • Affect her capacity for social and economic participation - section 24(1)(d) NDIS Act; and
   • Render her likely to require NDIS Supports for her lifetime - section 24(1)(e ) NDIS Act.

1. Dr Douglas Gray, rheumatologist provided a diagnosis fibromyalgia syndrome in 2016.[20]
2. Dr Lisa Carroll, rheumatologist has also confirmed the diagnosis of fibromyalgia.[21] Dr Carroll states in her letter dated 22 November 2024 that:

Fibromyalgia is a permanent condition that requires ongoing management but is not curable. All treatment options have been exhausted.[22]

1. Ms Gerada contends that she now also meets the 'disability requirements' as a consequence of her physical impairments due to fibromyalgia. These impairments include:
   • pain and weakness and a reduced range of movement in her shoulders, back, feet and arms;
   • pain from fibromyalgia which wakes her from sleep;
   • brain fog;
   • an inability to stand for longer than 10 minutes; and
   • pain if she sits for any longer than 20 minutes. ('impairments due to fibromyalgia').
2. Over the years Ms Gerada has tried a variety of treatments for her fibromyalgia which have included, nerve ablution of her spine and hips, cortisone injections, physiotherapy, slow-release pain medication and anti-inflammatory medication.
3. Ms Gerada now manages acute episodes of pain due to fibromyalgia with panadeine forte and heat packs. Dr McKeirnan, her general practitioner overseas this treatment.
4. Ms Gerada contends that her impairments due to fibromyalgia:
   • are permanent- section 24(1)(b) NDIS Act;
   • substantially reduce her functional capacity to undertake social interaction, mobility, and self-care. - section 24(1)(c ) NDIS Act. Ms Gerada stated that her ability to communicate is not impacted upon by her physical impairment due to fibromyalgia. In relation to her ability for learning Ms Gerada stated that she is 'unsure' if this is affected by fibromyalgia;
   • affect her capacity for social and economic participation - section 24(1)(d) NDIS Act;
   • render her likely to require NDIS Supports for her lifetime - section 24(1)(e ) NDIS Act.

1. Ms Gerada lives in her own two-bedroom unit in regional NSW. In her unit complex there is a communal driveway, grass area and garden.[23]
2. The goals in Ms Gerada's current plan are as follows:
   • To remain living independently in her own unit;
   • To have an effective workstation to reduce pain and allow her to be more productive at her desk;
   • To embark on an exercise plan to build flexibility, endurance and maintain her independence;
   • To embark on green therapy and aquatic landscape projects with her support worker to reduce her anxiety, manage her behaviours and increase the aesthetics of where she lives and enhance her ability to continue to remain living independently in her own unit;
   • To become more knowledgeable about schizophrenia and engage with her support networks and parents of children with mental illness. This goal is for the purpose of improving her family relationships including with her relationship with her daughter who has schizophrenia. It will also reduce her anxiety.
3. Ms Gerada provided the following oral evidence at the hearing:
   • She has attempted to manage her IBS over the years with a range of treatments including a FODMAP diet, Lomotil and loperamide medication for diarrhoea, a high fibre diet and by drinking a lot of water. She has also sought advice from a gastroenterologist and had multiple endoscopies and colonoscopies;
   • Her symptoms of IBS which include frequent and unpredictable bowel urgency and diarrhoea continue despite these treatments and lifestyle changes;
   • She manages her IBS by wearing continence pads at all times. Also by ensuring that she remains close to a toilet. This is done primarily on the basis that she rarely leaves her home. When Ms Gerada does leave the home she will wear continence 'pull-ups' underwear.[24]
   • Notwithstanding the use of continence pads Ms Gerada is subject to 'spillage' nine out of ten times;
   • She is extremely embarrassed by her incontinence;
   • Her IBS impacts greatly upon her agoraphobia. She explained that her IBS and agoraphobia 'work in together';
   • Due to agoraphobia Ms Gerada finds it impossible to leave her home. She explained that she had tried going into the community, 'but I can't';
   • She is unable to go to the shops due to her agoraphobia and her fear of incontinence;
   • She explained that there needed to be 'strict things in place' for her to go anywhere in the community so that she could manage her incontinence;
   • She is able to visit her podiatrist once a month, but only because it is a three-minute drive, there are no other patients present when she attends and there is a toilet and shower within the podiatrist's practice;
   • Her support workers help with her low motivation by converting her 'intentions' into 'actions'. They also assist her with planning tasks, sequencing, problem solving when she becomes overwhelmed and motivating her;
   • She described her support workers as providing 'cognitive scaffolding';
   • She has 6 children and 10 grandchildren;
   • She has contact with some of her children and grandchildren at various levels and frequency;
   • She has worked as a professional 'Resume writer' and would like to return to this role when these Tribunal proceedings are finalised and she has 'more time';
   • In the past she has been actively involved in community work with a youth centre near to where she lives;
   • In early 2025 she was the event coordinator for a youth crime meeting;
   • In the past she has received ECT as a treatment for her mental health. This treatment, has in her view, been detrimental to her cognition and adversely affected her sleep patterns;
   • Prior to ECT she considers that she was 'high functioning';
   • She has poor sleep hygiene and will often stay awake into the early hours of the morning.

1. Dr McKeirnan is Ms Gerada's general practitioner. He provided a number of reports[25] and also oral evidence at the hearing.
2. Dr McKeirnan has been Ms Gerada's general practitioner since 2016. In his oral evidence Dr McKeirnan referred to the following matters:
   • Ms Gerada's IBS is 'maximally treated';
   • 'Brain fog" is a well-known symptom of fibromyalgia;
   • He 'imagined' there would be an 'impact' on Ms Gerada's ability to carry out her activities of daily living if her level of funded support was taken away;
   • Ms Gerada was last reviewed by a gastroenterologist in or about 2016 and a more recent review 'might' be worth having;
   • Ms Gerada has not physically attended his medical practice since the commencement of the COVID pandemic;
   • Ms Gerada's has had no recent psychiatric review. Dr McKiernan explained 'once the diagnosis is established, then there's kind of no need';
   • In respect of monitoring Ms Gerada he stated, 'we're catching up and talking all the time' and that her symptoms 'haven't changed much over the years or at all'.
   • He has no reason to disbelieve any of the symptoms that Ms Gerada has reported to him.

1. Ms Baumer is an occupational therapist. Ms Baumer conducted an assessment of Ms Gerada in August 2025. Her assessment was detailed and comprehensive.[26] Her recommendation included support worker assistance, transport assistance with daily activities and in the community. It also included the following items;
   • Bed raisers;
   • A 'Handybar' for car transfers;
   • A shower seat that allows access to wash her bottom whilst seated;
   • A handsfree hair dryer;
   • Raised planter boxes to support physical engagement with gardening;
   • A compression for her wrist;
   • Continence products;
   • A 4 wheeled walker;
   • A sit to stand recliner;
   • A grab and towel rail combo;
   • An assessment for a bidet and possible prescription;
   • A vertical grab rail in the shower;
   • A reconfigured shower door;
   • Leaver taps;
   • Webster packs for medication.
2. Ms Baumer also provided oral evidence at the hearing.[27] Her evidence included the following opinions;
   • During her assessments of Ms Gerada, she would often become distracted from the conversation, loose a train of thought and have difficulty word finding and maintaining attention;
   • That her assessments concluded that when Ms Gerada 'had scheduled activities and plans' she was 'motivated to get out of bed and get dressed and do your grooming activities, even if it was a short time frame before the person's arrival';
   • Ms Baumer referred to Ms Gerada's lack of motivation and that she needs supports 'to encourage you to do it and to be able to help with the functional side of things in terms of physical requirements';
   • That Ms Gerada had a 'limited routine which is based around when she has her supports currently';
   • Ms Baumer referred to a 'graduated approach plan' for Ms Gerada to access the community over time. This plan would be based on Ms Gerada's tolerances and reactions in terms of her mental health and other symptoms;
   • Ms Baumer confirmed this recommendation as 'a very staggered and gradual gentle approach to any kind of approach to the community' explaining that 'it would be a good goal to work towards to increase that community engagement, but it would need to be well supported, yes.

1. Ms Zietsch is one of Ms Gerada's support workers. She provided a statement to the Tribunal[28] and oral evidence at the hearing.[29] In her oral evidence she referred to the following:
   • She provides support to Ms Gerada, generally twice a week. in the afternoons;
   • Ms Zietsch assists with a variety of tasks which include cleaning, laundry, changing bed linen and shopping. She explained that the majority of tine spent was in relation to cleaning tasks;
   • In relation to assistance with shopping she assists on a weekly basis. In relation to the preparation of a shopping list Ms Zietsch explained that when she arrives at Ms Gerada's home 'she generally has a list all done'
   • Ms Zietsch stated that she also assists Ms Gerada with administrative tasks in respect of the use of her computer. Ms Zietsch explained that she had an 'admin and finance background' and had 'used computers for a large part of my life'. On this basis she has been able to help Ms Gerada to 'give her some shortcuts and some assistance in regards to how she can do things a little bit easier, a little bit better'
   • Ms Zeitsch also explained that she had provided Ms Gerada with assistance in maintaining a spreadsheet and setting up 'folders' on her desktop. She stated that having helped Ms Gerada with 'set up' on her desktop Ms Gerada has thereafter been able to manage 'quite well';
   • Ms Zietsch explained that when she goes shopping for Ms Gerada she communicates with Ms Gerada via a shared 'live list' on their respective mobile phones. This enables continual communication with Ms Gerada while Ms Zietsch is in the process of shopping and making various grocery selections. Ms Zietsch explained 'So while I'm at the shop, she can be adding things or I can actually be communicating with her and sending her a photo saying, oh look, they don't have this type of yoghurt but they do have this one'
   • Ms Gerada's desire to continue as a volunteer committee member on the Body Corporate of her unit complex;
   • Ms Gerada's desire to return to resume writing;
   • that for most of the year Ms Gerada's 'time has been completely consumed with' the Tribunal proceedings,
   • That Ms Gerada had reported spending, at times, up to 8 hours a day at her computer desk which had resulted in pain in her hips, back, shoulders, neck and hands. In this regard Ms Zietsch clarified that during these periods of time Ms Gerada would however get up and down to go to the toilet, use the bathroom or get a drink;
   • That on some days, it is evident to her when she arrives at Ms Gerada's home that it has been effort for her to get up. Ms Zietsch explained,

'You have showered and you are dressed and you're ready for your day.

And I know that takes a lot of effort, but yeah, that that is that is you're up and you're ready for your day.

Subsection 34(1)(aa): Are the supports sought necessary to address the needs of Ms Gerada arising from the impairments in relation to which she meets the disability requirements?

1. Subsection 34(1)(aa) of the NDIS Act requires the Tribunal to determine whether the supports which are sought by Ms Gerada are necessary to address her needs arising from the impairment or the impairments for which she meets the 'disability requirements'.
2. When Ms Gerada was granted access to the scheme in June 2018 the Agency was satisfied, at that time, that she met the 'disability requirements' on the basis that she had psychosocial impairments due to the effects of major depressive disorder, other anxiety disorders and obsessive-compulsive disorder.
3. For the purposes of this review Ms Gerada contends that she continues to meet the' disability requirements' as a consequence of her psychosocial impairments as referred to at [28]. She contends also that she now meets the 'disability requirements' as a consequence of her impairments due to IBS and fibromyalgia as referred to at [34] and [41].
4. The use of the word 'meets' in subsection 34(1)(aa) of the NDIS Act is relevant to the timing of the Tribunal's consideration under this provision. Recently in TZQP v National Disability Insurance Agency [2025] ARTA 839[30] General Member Purcell provided the following commentary, with which I agree, in respect of the operation of subsection 34(1)(aa) of the NDIS Act and the Tribunal's task:
   1. ......... the Act uses the word 'meets'. In the Tribunal's view, this necessitates a current temporal assessment as to whether the impairment 'continues to meet' the disability requirements or early intervention requirements, as the case may be. This interpretation is supported by the note accompanying section 34(1) which states:

(a) the time at which the disability requirements or the early intervention requirements need to be met is the time the CEO decides to approve the statement of participant supports;

1. In performing it's review function, the Tribunal has the power to affirm, vary or substitute the reviewable decision made by a delegate of the CEO to approve the Applicant's statement of participant supports. Accordingly, the time at which the Applicant needs to meet the disability requirements for the purpose of section 34(1)(aa), is at the time of the Tribunal's decision. (Tribunal emphasis)
2. Therefore, for the purposes of subsection 34(1)(aa) of the NDIS Act the Tribunal tasks, in the following order, are as follows:
   • Firstly, as a starting point, an inquiry of whether Ms Gerada continues to meet the disability requirements on the basis of her psychosocial impairments, her physical impairments or both; and
   • Secondly, whether Ms Gerada has a 'need' which arises from the identified impairment or impairments for which she meets the disability requirements;
   • Thirdly, whether the particular support, for which funding sought, is necessary to address this 'need'.[31]
3. At this juncture I make the observation that it is imperative for all participants, who seek administrative review by the Tribunal, to recognise and appreciate, as a reality, that a participant's entitlement to access to the scheme, on the basis of having met the disability requirements 'historically' is not preserved ad infinitum. This is because, as a consequence of the insertion of subsection 34(1)(aa) of the NDIS Act by the Amending Act, the Tribunal must necessarily consider, at the time of its review, whether the participant continues to meet the disability requirements.
4. On the first day of the hearing Ms Gerada was placed on notice by the Tribunal of the task required under subsection 34(1)(aa) of the NDIS Act and that the Tribunal may conclude that she does not continue to meet the disability requirements as a consequence of any of her impairments. Ms Gerada contended there to be 'ample evidence' before the Tribunal to establish that she did in fact continue to meet the disability requirements as a consequence of her psychosocial and physical impairments.[32]
5. For completeness there was no contention by Ms Gerada that she met the early intervention requirements pursuant to section 25 of the NDIS Act.

Does Ms Gerada continue to meet the disability requirements?

1. The amendments to the NDIS Act on 3 October 2024 (referred to at [14]) also included an amendment to section 24 of the NDIS Act which contains the criteria for meeting the 'disability requirements'.
2. Item 126 of Schedule 1 to the Amending Act, provides that the amendments to section 24 of the NDIS Act apply to access requests that are made to the Agency by a 'prospective participant' on or after 3 October 2024. This means these amendments apply to access matters that are before the Tribunal if the prospective participant made an access request on or after 3 October 2024.
3. Ms Gerada is however already a participant in the scheme. Therefore, this application for review cannot be considered to be a request for access to the scheme. Notwithstanding, I have decided that section 24 of the NDIS Act, as amended, will apply for the purposes of this review. [33]
4. The 'disability requirements' contained in section 24 of the NDIS Act[34] for the purposes of this review provide as follows:
   1. A person meets the disability requirements if:

(a) the person has a disability that is attributable to one or more intellectual, cognitive, neurological, sensory or physical impairments or the person has one or more impairments to which a psychosocial disability is attributable; and

(b) the impairment or impairments are, or are likely to be, permanent; and

(c) the impairment or impairments result in substantially reduced functional capacity to undertake one or more of the following activities:

(i) communication;

(ii) social interaction;

(iii) learning;

(iv) mobility;

(v) self-care;

(vi) self-management; and

(d) the impairment or impairments affect the person's capacity for social or economic participation; and

(e) the person is likely to require NDIS supports under the National Disability Insurance Scheme for the person's lifetime.

1. For the purposes of subsection (1), an impairment or impairments that vary in intensity may be permanent, and the person is likely to require NDIS supports under the National Disability Insurance Scheme for the person's lifetime, despite the variation.
2. For the purposes of subsection (1), an impairment or impairments that are episodic or fluctuating may be taken to be permanent, and the person may be taken to be likely to require support under the National Disability Insurance Scheme for the person's lifetime, despite the episodic or fluctuating nature of the impairments.
3. Subsection (3) does not limit subsection (2).

Note 1: The time at which a requirement in this section needs to be met is the time the matter falls to be determined. For an access request, that time is the time of considering the request (see paragraph 21(1)(c)).

Note 2: National Disability Insurance Scheme rules may be made in relation to this section under subsection 27(1)

1. The requirements of section 24 of the NDIS Act are cumulative and all criteria must be met.
2. Section 27 of the NDIS Act provides for the making of rules in relation to the disability requirements. The relevant rules in respect of this review are the National Disability Insurance Scheme (Becoming a Participant) Rules 2016 ('the Access Rules').
3. Of most relevance to this review, is consideration of whether, at this point in time, Ms Gerada has a substantially reduced functional capacity in respect of one or more of the activities in subsection 24(1)(c) of the NDIS Act, as a consequence of any one or more of her impairments.
4. I have considered all of the impairments contended by Ms Gerada, both psychosocial and physical. For reasons which will follow I am not positively satisfied that Ms Gerada's functional capacity to undertake any of the activities in subsection 24(1)(c) of the NDIS Act is substantially reduced to the extent of the 'threshold' which is required for access to the scheme.

Do any of Ms Gerada's impairments, physical or psychosocial currently result in a 'substantially reduced functional capacity' for her to engage in the activities of communication, social interaction, learning, mobility, self-care and self-management - subsection 24(1)(c) NDIS Act?

1. In determining Ms Gerada's functional capacity for the purposes of subsection 24(1)(c) of the NDIS Act the following is relevant to the Tribunal's consideration:
   • The severity of Ms Gerada's impairments having regard not only to the evidence of Ms Gerada but also medical and clinical evidence;
   • The 'bundle of tasks' that fall within each of the activities in subsection 24(1)(c) of the NDIS Act;
   • Ms Gerada's overall 'functional capacity' in the 'activities' in subsection 24(1) (c) of the NDIS Act, as a whole and over time and taking into account fluctuations in her abilities;
   • A practical assessment of what Ms Gerada can do and cannot do.

1. The following however is not relevant to the Tribunal's consideration in determining Ms Gerada's functional capacity for the purposes of subsection 24(1)(c) of the NDIS Act:
   • The fact that Ms Gerada is no longer able to perform the activities in subsection 24(1)(c) of the NDIS Act as often, as freely, as quickly or as easily as she did previously in her lifetime;
   • Ms Gerada's financial circumstances;
   • Environmental factors such as unpleasant or abusive neighbours;
   • The fact that Ms Gerada has previously been funded as a participant under the scheme; and
   • How much better Ms Gerada's life would be if she were to receive supports under the scheme.
2. The Tribunal must undertake, with a high degree of precision, a functional, practical assessment of what Ms Gerada can and cannot do, at this point in time, with respect to her communication, social interaction, learning, mobility, self-care and self-management for the purposes of subsection 24(1)(c). This assessment requires consideration of the 'bundle of tasks' and actions that comprise any given activity being considered.[36]
3. Previously in the decision of Garcia Albiol v NDIA[37] I considered the use of the word 'substantially' as a descriptor of 'reduced functional capacity' in subsection 24(1)(c) of the NDIS Act. In doing so I determined that the term 'substantially' in the context of reduced functional capacity carries a 'high threshold'. That decision has not been appealed and has in fact been adopted in this Tribunal.[38]
4. My view of a 'high threshold' for reduced functional capacity remains unchanged.
5. The Agency accepts that Ms Gerada's functional capacity is 'impacted' when undertaking the various activities referred to in subsection 24(1)(c) of the NDIS Act. The Agency however contends that irrespective of whatever impairments affect Ms Gerada, the level of impact from these impairments upon Ms Gerada does not rise to the level of a 'substantial reduction' in her functional capacity, in any of the activity domains. The Agency also contends that Ms Gerada's oral evidence, demonstrates a higher capacity in each of the domains than was indicated from the documentary evidence alone.[39]
6. The Agency's submission was persuasive and is accepted. My reasons follow.

1. The Operational Guidelines describe mobility as follows:

Mobility, or moving around - how easily you move around your home and community, and how you get in and out of a bed or a chair. We consider how you get out and about and use your arms or legs.

2. In Madelaine the Tribunal held that the threshold requirements to achieve functional capacity with respect to mobility are 'relatively modest' stating that:[40]

A person has functional capacity if they can move about their home, get in and out of a bed or a chair, and mobilise in the community. Movement in the home does not need to be achieved by walking, a person might even crawl from room to room. The Concise Oxford Dictionary defines mobile as moveable, not fixed, free to move. > > The use of the phrase move around ... to undertake ordinary activities of daily living in the Guideline is significant. It implies some expectation of how far a person needs to be able to move to undertake ordinary daily activities, say, getting to the bathroom to wash or toilet, getting to the kitchen to prepare food, perhaps getting to the front letterbox to collect mail. Implicit in this concept is that the distances involved will be relatively short. Significantly, the concept does not include being able to move around in the community for the purpose of accessing services, such as shops, the bus stop or the local park - the phrase moving about in the community is not qualified in the same way that move about the home is qualified by to undertake ordinary activities of daily living. To define mobility by the ability to reach local services would be to make it a function of where one lived. A better application of the concept is to ask whether a person can move about in shops or a park once they have reached them, say by car or public transport. > > No particular distance is specified in the Guideline as defining this level of mobility, but it seems reasonable to suggest that a person who can travel 50 m by herself has the capacity to do the things referred to in the Guideline

3. Ms Rebecca Davison, occupational therapist assessed Ms Gerada in April and May 2024 and noted the following in respect of Ms Gerada;
   • She was observed to walk independently within her home;
   • She could independently undertake the following tasks:
     • sit to stand;
     • stand to sit;
     • lay to stand;
     • toilet transfer;
     • car transfer; and
     • bed transfer.[41]
4. Ms Vicki Stanley, occupational therapist also assessed Ms Gerada. Ms Stanley provided a report dated 22 August 2024[42] wherein she referred to the following:
   • Ms Gerada's reduced standing tolerance to ten minutes due to osteoarthritis;
   • An inability to walk more than 30-40 meters due to osteoarthritis;
   • An inability to safely complete lounge and chair transfers.
5. In August 2025 on the basis of her assessment Ms Baumer noted the following:
   • Ms Gerada enjoys gardening;
   • She can walk unaided around her home. She has a four wheeled walker and a walking stick, which she uses when her pain is exacerbated;
   • She was able to move between sitting and standing positions throughout her assessment;
   • She is able to walk up and down her driveway and along flat concrete for exercise;
   • She is able to walk from her car to her podiatrist's surgery;
   • She is able to walk on the grass in her garden;
   • She uses a long handled reacher to pick up items off the floor. When she drops this reacher she does however have difficulty accessing this item off the floor;
   • She sometimes uses furniture and walls for support when mobilising;
   • Ms Gerada can transfer 'onto and off the dining room chair and office chair without any significant concerns. She uses the table or the arms of chairs to push herself up to stand;
   • She uses a pole in situ on both sides of her bed to transfer in and out of bed;
   • She uses a removeable wooden bench to support her transfers onto and off the toilet;
   • She is able to use her arms to type in her notebook. Ms Baumer observed Ms Gerada to 'have large amount of writing in her notebook at the time of the assessment';
   • She can use her mobile phone and open lever door handles without concern;
   • She has difficulty opening bottles and jars and therefore uses an automatic bottle opener to assist;
   • She can put laundry in a washing machine. Ms Baumer stated 'She requires support for pegging out laundry due to difficulties reaching and lifting clothing items above her head and squeezing pegs as a result of pain in her shoulder, back and hands/wrists. Debra is unable to use a portable clothes horse due to limited space in her small unit
6. Ms Gerada provided oral evidence in relation to her ability to engage in the domain of mobility. This evidence included the following:
   • she no longer uses stairs. This is because she feels unsafe and anxious, is frightened of falling and feels wobbly;
   • she is able to independently mobilise inside her home;
   • she uses a walking stick a few times a month;
   • she uses grab rails in her bathroom and a bed stick next to her bed for transfers;
   • she uses the arms of her lounge chair for support for lounge chair transfers;
   • she is able to sit in a dining chair at a table;
   • she can independently get up down from an office chair;
   • she is able to mobilise to prepare small meals such as eggs or to heat pre-prepared meals in a microwave;
   • she uses a modified knife fork and spoon;
   • she is able to water her pot plants;
   • she is able to walk to the letterbox and collect her mail;
   • she is able to transfer in and out of a motor vehicle using a handy bar;
   • she is able to put on a seatbelt;
   • she can type on a keyboard and use a computer. This includes the ability to 'cut and paste';
   • she accepts that at times she sits for prolonged periods of up to 8 hours undertaking activities on her computer.[43]

1. I am satisfied based on the evidence that Ms Gerada's functional capacity to participate in the bundle of tasks comprised in the activity of mobility is not substantially reduced to the threshold required, as a result of any of her psychosocial or physical impairments.
2. Ms Gerada is clearly able to engage in the tasks associated with moving around and within her home. She is also able to mobilise within the outdoor area of her home including walking up and down her driveway. Ms Gerada contends that it is not 'safe' for her to mobilise in the outdoor area of her unit complex on the basis she is fearful of harassment from a neighbour. In her closing submissions she stated,

Each time I have attempted to access the driveway for basic purposes - such as walking for graded exposure, collecting mail, or simply leaving my home - I have been subjected to verbal abuse, intimidation, and harassment from the neighbouring residents.[44]

1. This reason for not accessing her driveway is not relevant to the Tribunal's consideration of her ability to mobilise. The Tribunal is concerned only with Ms Gerada's 'functional capacity' to mobilise and not the reason as to why Ms Gerada may 'choose' not to mobilise in a particular way or in a particular location.
2. Ms Gerada is able to sit at her computer desk for prolonged periods of up to 8 hours. During these periods of time, she is able to mobilise to use her computer for various purposes. Some of these purposes include research, community projects, resume writing, various legal proceeding which I will subsequently refer to, research, sending and receiving emails. On the basis of sitting for prolonged periods of up to eight hours it is unsurprising that Ms Gerada experiences pain and discomfort.
3. Ms Gerada is also able to engage in the tasks associated with transfers in and out of her bed, her computer chair, dining chairs and lounge chairs.
4. Ms Gerada is also able to engage in the tasks associated with mobilising for the purposes of her self-care including showering, toileting, meals and dressing herself. Throughout the hearing and over a period of five days, Ms Gerada was observed to mobilise easily on and off her office chair for a variety of reasons which included attending to visitors at her front door, trips to the toilet and to her printer.
5. Ms Gerada is able to travel as a passenger in a motor vehicle. She is also able to mobilise at the podiatrist's surgery.
6. In summary, having considered what Ms Gerada can and cannot do, over time, I have formed the view Ms Gerada does not meet the threshold required for a substantially reduced functional capacity in the activity of mobility on the basis of any impairment that may affect her.

1. The Operational Guidelines describe communication as follows:

Communicating - how you speak, write, or use sign language and gestures, to express yourself compared to other people your age. We also look at how well you understand people, and how others understand you.

1. In Madelaine v National Disability Insurance Agency ('Madelaine') the Tribunal considered 'communication functionally' in respect of an earlier (and not dissimilar) version of the Agency's Operational Guidelines.[45] In Madelaine the Tribunal described communication functionality to be of 'a fairly basic kind_: telling a family member about something that has happened, explaining to a doctor in what part of the body pain is experienced, asking for help to reach something and so on'._ (Tribunal emphasis)
2. Ms Rebecca Davison's assessment noted Ms Gerada was capable of the following tasks[46]
   • Independent verbal communication;
   • Able to engage in receptive communication during the assessment;
   • Able to independently use a telephone and access "Dragon Naturally";
   • Is independent with reading and writing tasks.
3. In her report Ms Davidson also stated, 'Debra is reported to access the internet independently to engage with others and to participate in her volunteer resume writing work'.[47]
4. Ms Gerada is able to speak to her general practitioner via telehealth.[48] She is also able to describe her concerns to her general practitioner.
5. As to functional capacity in relation to communication Ms Baumer referred to the following in respect of Ms Gerada:
   • She has functional receptive communication skills, however, can have difficulty retaining information if stressed or overwhelmed;
   • She is able to write and was observed to have large amounts of writing in her notebook;
   • She can use a mobile phone to communicate. This includes making calls and sending text messages;
   • She is able to use a computer to send emails;
   • She is able to communicate verbally, however does experience 'brain fog', difficulty finding words, stringing a sentence together and following her train of thought;
   • When her support workers are undertaking grocery shopping for her she is able to communicate with her support workers using a video call. Through this process, Ms Gerada is shown products available at the supermarket and encouraged to make choices;
6. Ms Baumer also stated in her report,

Debra has employment history working in an employment agency and supporting people to write a resume within a private practice before she retired in 2015. Debra continues to support people with writing needs including writing letters to members of parliament and supporting community groups as a volunteer. Debra was proud of her involvement in setting up programs for at risk families, and attending other community meetings via video link[49].

1. Ms Gerada provided the following oral evidence in relation to her ability to engage in the domain of communication:
   • her ability to communicate is impacted upon by her depression. She finds it hard to become motivated to communicate;
   • she has memory issues and prefers that information be provided in writing;
   • she will document conversations in writing once they have taken place;
   • at times she struggles to get words out and to sequence her words;
   • she is able to talk on the phone;
   • she can use Chat GPT to compile statements;
   • she is able to text, and send videos and photographs electronically;
   • she can access Instagram and does so with her grandchildren;
   • she is able to use a phone to send text messages and photographs;
   • She has a friend in Victoria and exchanges text messages with this friend most days;
   • She exchanges text messages with her sister each week;
   • She has regular phone calls with her sister 'up to twice a week'[50]
   • She is able to use voice to text on her mobile phone;
   • She is able to compose an email using voice to text;
   • She is able to communicate her concerns with her doctor using a tele-health service;
   • She is able to type and compose emails and use a computer. She described herself as 'fairly computer savvy';
   • She is able to text and speak to her children;
   • She speaks to tradespeople and is able to liaise with them when they arrive at her unit complex to provide services;
   • She is able to coordinate and organise community projects;
   • She has worked in the past as a professional resume writer and would like to return to this work when she has more time after the completion of these Tribunal proceedings.
2. Ms Gerada also provided lengthy type written statements to the Tribunal. These statements were well written both in structure and content and provided detailed information in relation to her various conditions and consequential symptoms. This included a 'personal record and reflection' on her experience with ECT.[51] Her closing submissions were structured 'by topic for clarity' and footnoted with references.
3. Ms Gerada represented herself at the hearing over a period of 6 days and was able to communicate orally, in an articulate manner, her point of view and contentions.
4. I am satisfied, based on the evidence, that Ms Gerada's functional capacity to participate in the bundle of tasks comprised in the activity of communication, is not substantially reduced, to the threshold required, as a result of any of her psychosocial or physical impairments.
5. Ms Gerada is clearly able to effectively engage in the expressive and receptive language tasks that form the bundle of tasks within the activity of communication.[52] These tasks include the ability to communicate both orally and using technology such as a mobile phone and a computer. She is able to express her concerns to other persons, including medical practitioners and allied health professionals. She is able to communicate orally and using text messages with her family and friends and does so on a regular basis.
6. Ms Gerada gave evidence that she is the 'contact person' on behalf of the body corporate for service contractors who attend at her unit complex. She is able to liaise with these contractors and provide information and instructions as and when required.
7. Ms Gerada's recent organisation of a community meeting for youth crime prevention in January 2025 demonstrates her ability to communicate also with the wider community and not only individuals on a one-on one basis.
8. I accept that Ms Gerada may have difficulties with communication due to impairments such as brain fog. Notwithstanding, having considered what Ms Gerada can and cannot do, over time, I have formed the view that she does not meet the threshold required for a substantially reduced functional capacity in the activity of communication on the basis of any impairment that may affect her.

1. The Operational Guidelines describe self-care as follows:

Self-care - personal care, hygiene, grooming, eating and drinking, and health. We consider how you get dressed, shower or bathe, eat or go to the toilet.

1. Ms Baumer states in her report that Ms Gerada 'completes the majority of personal care tasks independently, however, has some difficulty with motivation and initiating tasks without a motivating factor such as supports coming to her home'.[53]
2. In her report Ms Baumer noted the following:
   • that Ms Gerada presented as well-groomed with clean and appropriate clothing;
   • she uses a shower chair to bathe;
   • she uses a long-handled brush to wash her feet, legs and back;
   • she supports herself with a horizontal grab rail to stand and wash in the shower;
   • she was able to initiate and complete all showering tasks;
   • she has difficultly dressing and to do so:
     • wears lose fitting and stretchy clothing without buttons or zips;
     • uses a sock applicator to put on socks;
     • wears slip on shoes;
   • she is unable to manage a hair dryer and thus allows her hair to dry naturally;
   • she can brush her teeth independently;
   • she manages her fingernails with small scissors and a nail file;
   • she requires the support of a podiatrist to manage her toenails;
   • she is able to apply makeup independently and was 'well presented' at the time of Ms Baumer's assessment;
   • Ms Gerada can experience up to ten bowel movements per day. She uses a post-partum peri bottle to manage cleaning herself after bowel movements. Often, she will also shower after a bowel movement;
   • she eats Lite n' easy for lunch and dinner;
   • she appeared to have good insight when her mental state is well managed and historically has self-admitted herself to a private mental health clinic in in the context of decline.

1. Ms Gerada provided oral evidence in relation to her ability to engage in the activity of self-care. This evidence included the following;
   • she uses a shower brush and sits on a shower stool to bathe;
   • she is able to use soap and shampoo herself;
   • she can dress and undress herself and wears loose clothes;
   • she is able to brush her teeth and blow dry her hair using a hands-free hairdryer;
   • she is able to apply make-up and wash her face and hands as required;
   • she manages her own medication;
   • she is able to communicate with her support workers via text messages and photos when her support workers are purchasing groceries for her;
   • she is able to use the Internet to look for clothing;
   • she can wipe down a kitchen bench;
   • she can load a washing machine.
2. Currently Ms Gerada receives assistance from her support workers, funded under the scheme, to prepare shopping lists and undertake grocery shopping within a supermarket on her behalf. Having regard to Ms Gerada's demonstrated aptitude with Technology I see no reason why Ms Gerada could not also do online grocery shopping should she choose to do so.
3. I am satisfied based on the evidence that Ms Gerada's functional capacity to participate in the bundle of tasks comprised of the activity of self-care is not substantially reduced to the threshold required as a result of any of her psychosocial or physical impairments.
4. Ms Gerada is able to undertake a range of tasks in respect of her selfcare which included independently managing her personal hygiene, toileting, bathing, grooming, medication, eating and drinking. Ms Gerada generally eats Lite b Easy meals however has the ability to prepare additional food during the day when she is hungry. [54]She is also able to manage her healthcare independently which includes organising appointments and explaining to her doctor any concerns. She is able to dress herself and present well prior to receiving visitors to her house.
5. In summary, having considered what Ms Gerada can and cannot do, over time, I have formed the view Ms Gerada does not meet the threshold required for a substantially reduced functional capacity in the activity of self-care on the basis of any impairment that may affect her.

1. The Operational Guidelines describe self-management as follows;

Self-management - how you organise your life. We consider how you plan, make decisions, and look after yourself. This might include day-today tasks at home, how you solve problems, or manage your money. We consider your mental or cognitive ability to manage your life, not your physical ability to do these tasks.

1. In her evidence Ms Baumer referred to the following:
   • that Ms Gerada organises support for her younger children when required. In particular, she regularly assists one of her children who is affected by a mental illness;
   • Ms Gerada retired in 2015. Notwithstanding Ms Gerada 'continues to support people with writing needs including writing letters to members of parliament and supporting community groups as a volunteer. Debra was proud of her involvement in setting up programs for at risk families, and attending other community meetings via video link.'
   • when Ms Gerada's mental health is managed effectively she is independent with her health management, this includes range health appointments;
   • she is able to plan and sequence tasks effectively;
   • she manages her own medications, but does have some difficulty opening bottle lids when experiencing pain in her hands;
   • her ability to negotiate contracts with a service provider Luke Stone;
   • in the past 2 years she has been involved in a variety of legal proceedings aside from her application to the Tribunal. These have included an application to NCAT, applications to the Magistrates Court for Apprehended Violence Orders against other persons and defamation proceedings against a real estate agent. She has also attended a mediation in relation to a dispute with another unit holder in her unit complex.

1. Ms Davison stated in her report, 'Debra is part of the Strata Committee and takes great pride in improving the living environment for herself and other residents.'[55]
2. Ms Davison also stated that Ms Gerada reported that she was independent in money management.[56]
3. Ms Gerada's oral evidence in relation to her ability to engage in the activity of self-management included the following;
   • she manages her own bank account. Her bills are paid using a direct debit facility. She is able to 'check' her bank account;
   • she is able to help her youngest daughter who suffers from a mental health illness. [57]She described recently assisting her daughter to 'look for a job'
   • She is able to review and manage invoices for NDIS services;
   • She keeps a diary;
   • she is the 'contact person' in her unit complex and assumes responsibility for liaising with contractors when they attend at the unit complex to provide services. She describes herself as being 'abreast' of all maintenance issues;
   • She is involved in the organisation of a community project.
4. In her closing submissions Ms Gerada states;[58]

Fibro fog (cognitive dysfunction) and fatigue mean I struggle with complex tasks, scheduling, remembering appointments or managing my household effectively. I have made mistakes in taking medication due to brain fog. This overlaps with my mental health, but fibromyalgia contributes a distinct cognitive load.

1. I am satisfied based on the evidence that Ms Gerada's functional capacity to participate in the bundle of tasks comprised of the activity of self-management is not substantially reduced to the threshold required as a result of any of her psychosocial or physical impairments.
2. Ms Gerada is able to undertake a range of tasks in respect of her personal organisation and planning, personal decision making including in relation to her health, self-care, problem solving, preparing shopping lists and also her financial management.[59] She is also able to arrange and attend medical appointments.
3. Aside from these Tribunal proceedings Ms Gerada has recently been able to initiate and instruct in respect of other legal proceedings as referred to in [113].
4. Ms Gerada's functional capacity extends also to the ability to manage others. She is able to instruct contractors for works and services on behalf of the body corporate of her unit complex. She is also able to assist others with the management of their life such as her youngest daughter. She is also possessed of the skillset to have recently organised a community meeting.
5. In summary, having considered what Ms Gerada can and cannot do, over time, I have formed the view Ms Gerada does not meet the threshold required for a substantially reduced functional capacity in the activity of self-management on the basis of any impairment that may affect her.

1. The Operational Guidelines describe learning as follows:

Learning - how you learn, understand and remember new things, and practise and use new skills

1. Ms Baumer referred to the following matters in respect of Ms Gerada's ability to engages in the activity of learning:
   • She enjoys research and writing;
   • She is able to complete 1-2 steps instructions but has difficulty with 3 steps.
2. Ms Davison referred in her report to Ms Gerada enjoying researching the 'Strata Scheme Act' and 'Class Bento'.[60]
3. Ms Gerada provided oral evidence in relation to her ability to engage in the activity of learning. This evidence included the following:
   • she considers her ability to learn new things is impacted upon by brain fog and depression;
   • she finds it hard to motivate herself to learn new things due to processing and memory issues;
   • she will write notes to document phone calls;
   • she enjoys research and writing;
   • she is able to undertake internet research in relation to health for children and pregnancy. She is also able to watch garden videos;
   • She has learnt to use Chat GPT to compile statements;
   • She recently 'researched' an orthopaedic operation[61].

1. I am satisfied based on the evidence that Ms Gerada's functional capacity to participate in the bundle of tasks comprised of the activity of learning, over time, is not substantially reduced to the threshold required as a result of any of her psychosocial or physical impairments.
2. In Madelaine the activity of learning was explained as having the cognitive capacity to absorb and apply new skills. Furthermore, that the activity of learning should not be confused with 'higher order issues'.[62]
3. I am satisfied that Ms Gerada has the skills to acquire, absorb and understand new technology as evidence by her recent ability to learn and use Chat GPT for the purposes of these proceedings. She also has the skills to acquire new knowledge by undertaking research in relation to a variety of topics and enjoys doing so. Ms Gerada made reference to her legal research in her closing submissions referring also to case law.[63]
4. In respect of her online craft program Ms Gerada states that her support workers help her to 'break down complex information when brain fog impairs my cognitive processing';[64]. This refers to a 'higher order' of learning and not the threshold level for a substantially reduced functional capacity.
5. In summary, having considered what Ms Gerada can and cannot do, over time, I have formed the view Ms Gerada does not meet the threshold required for a substantially reduced functional capacity in the activity of learning on the basis of any impairment that may affect her.

1. The Operational Guidelines describe social interaction as follows:

Socialising - how you make and keep friends or interact with the community...We also look at your behaviour, and how you cope with feelings and emotions in social situations.

1. In Madelaine the Tribunal held, 'The criteria referred to in the Guideline are directed principally at personal skills needed for social interaction, and only marginally about opportunities to exercise those skills.'[65]
2. In Kilgallin and NDIA the Tribunal observed the following in relation to the threshold requirements for social interaction:[66]

Social interaction as referred to in 24(1)(c)(ii) doesn't, in our view, mean social interaction with the whole of the community. It means social interaction with elements of the community, sections of the community.

3. Ms Gerada lives alone in rural NSW. She has six children She reports that she does not see her children regularly, however she speaks to them on the telephone at regular intervals.
4. Ms Gerada has a friend who she sees approximately every six weeks.[67] She also has contact with her sister using telephone and SMS.[68]
5. Ms Gerada's oral evidence in relation to her ability to engage in the activity of social interaction included the following:
   • she is embarrassed to have visitors to her home, other than support workers and allied health professionals. This is on the basis that she may need to use the toilet urgently at any given time;
   • she has a neighbour in her unit complex that she speaks to. Her neighbour will often prepare her meals;
   • she belongs to an online community group. She also does research for young mothers;
   • she enjoys an online craft program known as 'Class Bento'. She has however stopped taking 'Class Bento' classes to dedicate time to these ART proceedings;
   • she has been involved in a youth crime protection and prevention project. In January 2025 she organised a community meeting for this project;
   • she provides services to others as a 'resume writer';
   • she considers that her ability to interact socially is impacted upon by her lack of motivation as a consequence of depression. It is also impacted upon by levels of fatigue due to fibromyalgia;
   • she speaks with her sister generally each week, for a period of up 2 hours;
   • she has contact by text with a friend, generally on a daily basis;
6. Under cross examination Ms Gerardo provided the following further evidence:
   • aside from a monthly podiatry appointment she has, in effect, not left her home to go to the shops since 2020, save for one hairdressing appointment. Ms Gerardo stated 'I just can't, it's just not possible';
   • Ms Gerardo explained that her inability to leave her home was due to her agoraphobia, compounded by her IBS;
   • she described her fear of incontinence in public and the difficulties in managing her incontinence in a community setting with respect to the changing of her underwear and the cleaning of her body;
   • Ms Gerada stated that even with continence pads she is still unable to go to the into the community. Further, that it was unfair of the Agency to expect her to do this;
   • Ms Gerada also stated that she did not feel that proper continence products would make a difference with the management of her diarrhoea due to IBS when accessing the community.
7. Ms Baumer described Ms Gerada as being 'socially isolated and experiencing occupational deprivation as a result of her psychosocial disabilities, physical limitations and significant difficulty managing irritable bowel syndrome.'[69]
8. In her report Ms Baumer noted the following:
   • Ms Gerada displayed appropriate social skills at the time of her assessment;
   • Ms Gerada has one friend who visits her 6-8 weekly;
   • She enjoys watching the television;
   • She 'uses technology to communicate and engage socially such as when engaging in community groups and meetings';
   • She enjoys spending time in her the garden area of her unit complex. Ms Baumer described this as a 'meaningful activity'. Ms Baumer also stated 'She enjoys being a part of gardening tasks with her support workers';
   • She is engaged with various community groups and projects. Ms Baumer also stated, 'She reported she has supported with writing applications and letters for funding and support including supporting vulnerable families. As Debra does not leave her home, she has engaged in these activities over video link from home.'
   • Her IBS limits her social interaction to those who will visit her at home;
   • She has six children. Despite a history of relationship difficulties her children recently visited her for her birthday and for Mother's Day;
   • In the past she has had a number of close friends. She has lost contact with these friends as she is 'very self-conscious about the weight she has a gained' stating that she did not want these friends 'to see me like this'
   • She can use technology to engage socially in community groups and meetings;
   • She enjoys 'green therapy'.[70]
9. In her report Ms Davidson stated, 'Debra is reported to access the internet independently to engage with others and to participate in her volunteer resume writing work'.[71]
10. As stated in Madelaine the activity of social interaction focuses upon the skills to interact and not the opportunities for interactions.
11. I am satisfied based on the evidence that Ms Gerada's functional capacity to participate in the bundle of tasks comprised of the activity of socialisation, over time, is not substantially reduced to the threshold required as a result of any of her psychosocial or physical impairments.
12. Despite rarely accessing the community and remaining within the confines of her home Ms Gerada does have the personal skills to interact socially with other people.
13. Ms Gerada interacts regularly with friends and family using the telephone to speak and to send and receive test messages. She has been able to maintain these as meaningful relationships. She also has the social skills to engage, using technology with the wider community as evidenced by her involvement in a leadership role with a community group program.,
14. She has a friend who visits her at her home generally every six weeks. Her children also visit her in her home from time to time.
15. The focus of subsection 24(1)(c) of the NDIS Act is upon a person's 'capacity' to undertake the relevant activities. It is not upon a person's willingness to undertake the relevant activities, no matter how good the reason.[72] The fact that Ms Gerada has lost contact with a number of the friends over the years due to her embarrassment in respect of weight gain is not the measure. She remains encumbered with the requisite skillset to re-engage with these friends for example by telephone should she choose to do so.
16. In summary, having considered what Ms Gerada can and cannot do, over time, I have formed the view Ms Gerada does not meet the threshold required for a substantially reduced functional capacity in the activity of social interaction on the basis of any impairment that may affect her.

1. For the following reasons the deeming provisions under Rule 5.8 of the Access Rules do not assist Ms Gerada in satisfying the Tribunal that she has a substantially reduced functional capacity for any of the activities in subsection 24(1)(c) of the NDIS Act.
2. Rule 5.8 of the Access Rules provides as follows:

When does an impairment result in substantially reduced functional capacity to undertake relevant activities?

5.8 An impairment results in substantially reduced functional capacity of a person to undertake one or more of the relevant activities - communication, social interaction, learning, mobility, self-care, self-management (see paragraph 5.1(c)) - if its result is that:

(a) the person is unable to participate effectively or completely in the activity, or to perform tasks or actions required to undertake or participate effectively or completely in the activity, without assistive technology, equipment (other than commonly used items such as glasses) or home modifications; or

(b) the person usually requires assistance (including physical assistance, guidance, supervision or prompting) from other people to participate in the activity or to perform tasks or actions required to undertake or participate in the activity; or

(c) the person is unable to participate in the activity or to perform tasks or actions required to undertake or participate in the activity, even with assistive technology, equipment, home modifications or assistance from another person.

1. Rule 5.8(a) of the Access Rules requires the Tribunal to assess whether Ms Gerada can participate 'effectively or completely' in any of these activities in subsection 24(1)(c) of the NDIS Act on the basis that she is unaided by assistive technology, equipment or home modifications other than 'commonly used items'.

• 153. The interpretation of 'commonly used items' was considered by the Tribunal in Rooney and National Disability Insurance Agency ('Rooney').[73] In Rooney the Tribunal identified the indicia in respect of what are to be considered 'commonly used items' for the purpose of rule 5.8(a) of the Access Rules. This indicium included items which are:
  • generally accessible;
  • can be used without the need for complex or specialised customisation or installation;
  • relatively simple to use; and
  • relatively inexpensive.

1. Ms Gerada's evidence is that she uses:
   • a four wheeled walker and a walking stick when her pain is exacerbated;[74]
   • a long handled reacher to pick up items off the floor;[75]
   • a wooden bench to assist with support for toilet transfers;
   • an automatic bottle opener;
   • a modified knife fork and spoon;
   • a pole beside her bed to assist with bed transfers
   • a 'handy bar' for car transfers which is a portable support handle that fits into a car door's striker plate to help people get in and out of their vehicles more easily and safely;
   • a shower brush and a shower stool to bathe;
   • a sock applicator to put on socks;
   • a hands-free hairdryer; and
   • a notepad to assist with her memory. [76]
2. I am satisfied that all of these items fall well within the category of 'commonly used items' for the purposes of rule 5.8(a) of the Access Rules.
3. I am also satisfied that Ms Gerada cannot rely upon the deeming operation of rule 5.8 of the NDIS Rules to satisfy the requirements of subsection 24(1)(c) of the NDIS Act. This is on the basis that she relies only on commonly used items to ambulate and mobilise, bathe, dress, self-care and eat. There is also no evidence that she currently relies on any assistive technology, complex building modifications or equipment to undertake tasks that form the 'relevant activities' under subsection 24(1)(c) of the NDIS Act.
4. Ms Gerada contends that she has low motivation and that her support workers help her by converting her 'intentions' into 'actions'. They also assist her with planning tasks, sequencing, problem solving when she becomes overwhelmed and motivating her. I am not satisfied however that Ms Gerada usually requires assistance (including physical assistance, guidance, supervision or prompting) from any other person to participate in the activities in subsection 24(1)(c) of the NDIS Act, or to perform tasks or actions required to undertake or participate in these activities. As referred to in these reasons Ms Gerada is clearly able to independently engage in a bundle of tasks within each activity. This engagement is predominately of her own volition and in her own timing, without any need for physical assistance, guidance, prompting or supervision from another person.

Conclusion - subsection 24(1)(c) of the NDIS Act

1. I accept that Ms Gerada has psychosocial and physical impairments as she contends. However, I am not satisfied that these impairments, either singularly, collectively or in any combination, rise to the 'threshold' of rendering her with a 'substantially reduced functional capacity' for any of the activities in subsection 24(1)(c) of the NDIS Act. On this basis Ms Gerada does not continue to meet the 'disability requirements'.
2. In Mulligan Mortimer J held as follows:

The access criteria in Ch 3 of the Act are an essential component of the NDIS as conceived. They are designed to impose a number of thresholds on access to the NDIS. By s 13, broad and general provision may be made for persons with disabilities - but access to the NDIS, and the supports, funding and autonomy it is intended to deliver, is reserved for a subcategory of persons with disabilities.[77] (Tribunal emphasis)

1. Ms Gerada does not, in my opinion, fall into this 'subcategory'.
2. Having failed to continue to satisfy the 'disability requirements' the Tribunal's remaining tasks for the purposes of subsection 34(1)(aa) of the NDIS Act as referred to at [57] are rendered obsolete. It follows that having failed to satisfy subsection 34(1)(aa) of the NDIS Act the supports sought by Ms Gerada are unable to be considered reasonable and necessary for the purposes of funding under the scheme.

1. This decision does not affect Ms Gerada's current status as a participant of the scheme. It is a matter for the Agency to take further action pursuant to section 30 of the NDIS Act in relation to revocation of her participant status. Any decision to revoke Ms Gerada's status as a participant in the scheme is a separate reviewable decision pursuant to section 99 of the NDIS Act.

1. Pursuant to subsection 105(c)(ii) of the Administrative Review Tribunal Act 2024 (Cth) the decision under review is set aside. The matter is remitted to the Agency for reconsideration with a direction that the Applicant does not meet the requirements of subsection 24 of the National Disability Insurance Scheme Act 2013 (Cth) in relation to impairments arising from fibromyalgia, agoraphobia, irritable bowel syndrome, major depressive disorder, any other anxiety disorder or obsessive-compulsive disorder and the supports requested in relation to these impairments are therefore not reasonable and necessary supports

I certify that the preceding 163 (one hundred and sixty-three) paragraphs are a true copy of the reasons for the decision herein of Senior Member J Collins.

[2] T1A, Subsection 100(6) NDIS Act, T1E.

[7] Section 129 of the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No 1) Act 2024.

[8] McGarrigle v National Disability Insurance Agency [2017] FCA 308 ('McGarrigle').

[10] National Disability Insurance Agency v WRMF [2020] FCAFC 79 ('WRMF').

[11] Minister for Home Affairs v G [2019] FCAFC 79 at [18].

[12] [1979] AATA 179 (1979); 2 ALD 634.

[13] [2018] FCA 1229.

[18] Agoraphobia - Wikipedia

[23] S1.

[24] Rebuttal of Respondent's closing submissions filed 21 November 2025 at page 18.

[25] T1F, PIA -B27, PIA -B31, PIA- B35, A2, A17, A42.

[31] See also TZQP v National Disability Insurance Agency [2025] ARTA 839 at 199.

[32] Rebuttal of the Respondent's Closing Submission filed 21 November 2025.pages 2 and

[33] TZQP v CEO NDIA [2025] ARTA 839 at 33

[34]35 Pursuant to Items 125 and 129 of the transitional provision in Part 3 of Schedule 1 to the National Disability Insurance Scheme Amendment (Getting the NDIS Back on Track No 1) Act 2024 (the Amending Act) the 'disability requirements' as they existed before the commencement of the amending act on 3 October 2024 will apply.

[37] Garcia Albiol v NDIA [2024] AATA 496.

[38] Moxham v CEO,NDIA [2025] ARTA 290_; Foster v NDIA_ [2025] ARTA 718_; TZQP v CEO, NDIA_ [2025] ARTA 839_; Coffey v CEO, NDIA_ [2025] ARTA 634_; Burrows v CEO,NDIA_ [2025] ARTA 607_; BFYK v NDIA [2025] ARTA 1006; KNNW v NDIA_ [2025] ARTA 1033_; Foster v NDIA_ [2025] ARTA 718_._

[39] Recording 13 November 2025- Agency's closing submissions.

[45] Madelaine v National Disability Insurance Agency [2020] AATA 4025 at [79].

[50] Applications closing submission at [28].

[51] T1J, T6, T7 , A10, A12, A23, A24, A33, A39.

[52] Burrows v NDIA [2025] ARTA 697 at 87.

[63] Applicant's closing submissions ayt [33].

[64] Application closing submissions filed 21 November 2025 ay [15].

[66] Kilgallin and NDIA [2017] AATA 186 at [18].

[73] Rooney and National Disability Insurance Agency [2021] AATA 3523.